Personal Counseling and Web-Based Strategies
Show Modest Success for Sustaining Weight Loss, According to
NHLBI Study

Adults who lost weight in a six-month program were able to keep
at least some of the weight off for 2.5 years with the help of
brief monthly personal counseling, according to a new study from
the National Heart, Lung, and Blood Institute (NHLBI) of the National
Institutes of Health. A Web-based intervention also helped participants
keep the weight off for two years, but the benefit waned during
the last six months of the trial.

The results of the Weight Loss Maintenance Trial, the largest
and longest duration trial to test different weight-loss maintenance
strategies, are published in the March 12, 2008, issue of the Journal
of the American Medical Association. Results will also be
presented at the American Heart Association's Nutrition, Physical
Activity, and Metabolism Council Meeting on March 12 in Colorado
Springs, Colo.

"Maintaining a healthy weight is a key tenet of every heart
disease prevention plan. We have well-tested techniques for successful
weight loss, but preventing weight re-gain is especially challenging.
This study provides insight into best practices for practical interventions
that can help adults keep the weight off and therefore lower their
risks for heart disease and other conditions," said Elizabeth
G. Nabel, M.D., director, NHLBI.

The study initially enrolled 1,685 overweight or obese adults
with high blood pressure or high cholesterol or both. Of those,
1,032 lost an average of 18.7 pounds during an initial six-month
weight loss intervention involving 20 weekly group-counseling sessions
which emphasized a heart-healthy dietary pattern and three hours
per week of physical activity. They were then randomly assigned
to one of three strategies for weight loss maintenance: monthly
personal counseling on diet and physical activity, a Web-based
intervention with the same advice, and self-direction, where participants
received minimal further intervention from study staff.

At the end of the study, participants receiving personal counseling
retained an average weight loss of 9.2 pounds, compared to an average
of 7.3 pounds for those using the Web-based intervention and 6.4
pounds for those in the self-directed group.

Personal counseling sessions were brief and mainly by telephone.
The Web site was developed to provide the same advice as personal
counseling. Both interventions were designed to be practical to
implement in a variety of settings.

"Most people in the study regained at least some of the weight
they initially lost. However, both the personal counseling and
the Web-based program modestly alleviated weight re-gain for up
to two years, with the personal counseling ultimately proving to
be the most beneficial by the end of the 2.5 year study," said
Laura Svetkey, M.D, a professor of medicine at Duke University
Medical Center, and the study's lead author.

Maintaining a healthy weight is an important part of heart disease
prevention. Weight loss is shown to lower blood pressure, lower
LDL "bad" cholesterol, and help prevent type 2 diabetes.
Each 2.2 pounds of weight loss can lower blood pressure by one
point and can lower the risk of developing diabetes by 16 percent
in high-risk adults.

"The relatively long-term, 24-month success of the Web-based
intervention shows promise particularly because of the potential
to reach a large number of adults at a relative low cost per person," said
Catherine Loria, Ph.D., program officer at NHLBI, and a study co-author. "We
need to continue working to improve both interventions so that
they are more effective and can be implemented widely."

Approximately 38 percent of participants were African-American
and 37 percent of participants were men.

To request an interview with an NHLBI spokesperson, please contact
the NHLBI Communications Office at (301) 496-4236 or nhlbi_news@nhlbi.nih.gov.
To request an interview with Dr. Svetkey, please contact the Duke
University Medical Center communications office at (919) 660-1306
or email Michelle Gailiun at michelle.gailiun@duke.edu.

Part of the National Institutes of Health, the National Heart,
Lung, and Blood Institute (NHLBI) plans, conducts, and supports
research related to the causes, prevention, diagnosis, and treatment
of heart, blood vessel, lung, and blood diseases; and sleep disorders.
The Institute also administers national health education campaigns
on women and heart disease, healthy weight for children, and other
topics. NHLBI press releases and other materials are available
online at www.nhlbi.nih.gov.

The National Institutes of Health (NIH) — The Nation's
Medical Research Agency — includes 27 Institutes and
Centers and is a component of the U.S. Department of Health and
Human Services. It is the primary federal agency for conducting
and supporting basic, clinical and translational medical research,
and it investigates the causes, treatments, and cures for both
common and rare diseases. For more information about NIH and
its programs, visit www.nih.gov.